Block
Block Title
Instructions
Number
4 – Fully Successful
Employee meets all requirements and exceeds one or several of the
requirements of the individual element.
10
5 – Exceeded Expectations
Superior. Employee consistently exceeds the performance
requirements.
11
Knowledge of the Job/
Ability to acquire, apply, and share technical and administrative
Professional Competence:
knowledge and skills associated with description of duties. (Includes
operational aspects such as marine safety, seamanship, airmanship,
SAR, etc., as appropriate.)
12
Ability To Obtain
Quality, quantity, timeliness, and impact of work.
Performance/Results:
13
Planning/Preparedness:
Ability to anticipate, determine goals, identify relevant information, set
priorities and deadlines, and create a shared vision of the Incident
Management Team (IMT).
14
Using Resources:
Ability to manage time, materials, information, money, and people (i.e.,
all IMT components as well as external publics).
15
Adaptability/Attitude:
Ability to maintain a positive attitude and modify work methods and
priorities in response to new information, changing conditions, political
realities, or unexpected obstacles.
16
Communication Skills:
Ability to speak effectively and listen to understand. Ability to express
facts and ideas clearly and convincingly.
17
Ability To Work on a Team:
Ability to manage, lead and participate in teams, encourage
cooperation, and develop esprit de corps.
18
Consideration for
Ability to consider and respond to others’ personal needs, capabilities,
Personnel/Team Welfare:
and achievements; support for and application of worklife concepts
and skills.
19
Directing Others:
Ability to influence or direct others in accomplishing tasks or missions.
20
Judgment/Decisions Under
Ability to make sound decisions and provide valid recommendations by
Stress:
using facts, experience, political acumen, common sense, risk
assessment, and analytical thought.
21
Initiative
Ability to originate and act on new ideas, pursue opportunities to learn
and develop, and seek responsibility without guidance and
supervision.
22
Physical Ability for the Job:
Ability to invest in the IMT’s future by caring for the physical health and
emotional well-being of self and others.
23
Adherence to Safety:
Ability to invest in the IMT’s future by caring for the safety of self and
others.
24
Remarks
Enter specific information on why the individual received performance
levels.
25
Rated Individual (This rating
Enter the signature of the individual being rated. Enter the date
has been discussed with me)
(month/day/year) and the time (24-hour clock) signed.
• Signature
• Date/Time
26
Rated by
Enter the name, signature, home unit, and position held on the incident
• Name
of the person preparing the form and rating the individual. Enter the
date (month/day/year) and the time (24-hour clock) prepared.
• Signature
• Home Unit
• Position Held on This
Incident
• Date/Time